Trichorrhexis nodosa L67.0

Wilks 1859; Beigel 1855;

Acquired or (more rarely) congenital nodular hair shaft alteration with dull, rough, split, easily broken hair.

Causally, defects in the cuticle lead to loss of cortical cells and intercellular cementum and eventually to imcomplete shaft fractures. The phenomenon may be:

be congenital:

• Trichothiodystrophy
• Argininosuccinic acid syndrome
• Biotinidase defect
• Trichohepatoenteric syndrome 1;

Or far more commonly acquired:

• Physical or chemical noxae. Nodular hair shaft abnormalities may occur proximally (due to tight hair styles) or distally (after repeated chemical or mechanical hair procedures - e.g., hair bleaching, hair straightening). In African-Americans who straighten their natural hair frizz, the phenomenon is common (Haskin A et al. 2017).

Trichorrhexis nodosa is often combined with trichoptilosis.

Periodic thickening of the hair shaft due to bristle-brush-like splintering of the hair.

1. Haskin A et al (2017) Breaking the cycle of hair breakage: pearls for the management of acquired trichorrhexis nodosa. J Dermatologist Treat 28:322-326.
2. Hwang ST et al (2013) Trichorrhexis nodosa after hair transplantation: dermoscopic, pathologic and electron microscopy analyses. Dermatol Surgery 39: 1721-1724
3. Kharkar V et al (2011) Trichorrhexis nodosa with nail dystrophy: diagnosis by dermoscopy. Int J Trichology 3:105-106
4. Lünnemann L et al (2013) Hair-shaft abnormality in a 7-year-old girl. Trichorrhexis nodosa dueto biotinidase deficiency. JAMA Dermatol 149:357-363
5. Ogunbiyi A et al.(2014) Recurrent hair loss resulting from generalized proximal trichorrhexis nodosa in a Nigerian female. Int J Trichology 6:83-84
6. Sisto T et al (2015) Inability to grow long hair: a presentation of trichorrhexis nodosa. Cutis 95:E15-16